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A fresh start for adult social care inspections?

Blog, 16 October 2013

Andrea Sutcliffe, the Care Quality Commission’s (CQC) new chief inspector of adult social care, has outlined a “fresh start” for the regulation of adult social care services. But Dan Parton asks, 'Will it be?':

The changes have been heralded as a new era for adult social care, with the CQC launching a new inspection regime – to come in from Autumn 2014 – that will more effectively root out and address poor care.

The CQC proposes a raft of changes to the inspection regime, which, on the face of it, seems like progress. While much of the mainstream media coverage has focused on the possible use of hidden cameras to monitor services – a potential legal minefield to my mind – other changes could lead to improvements.

For example, Sutcliffe has warned care providers that she is prepared to use the powers at her disposal to impose sanctions – including fines and closing down failing services – in more cases than they have been to date.

One of the criticisms of the CQC has been that the watchdog hasn’t used its teeth as much as it could – or perhaps should – have done. Combined with help for failing services to improve, a more robust approach would provide a decent carrot-and-stick for providers.

Additionally, more scrutiny will be placed on those wishing to register as care services by ensuring that those who apply to run them have the right values, motives, ability and experience. Again, this seems sensible, although what constitutes the right values etc is not explained in depth.

Other reforms are welcome, such as inspection teams including a professional expert in the field among their number. To me, this would seem like an obvious inclusion, but better late than never, I guess.

The inclusion of experts by experience – care users, family members and other advocates – is also welcome. They were utilised in the CQC’s inspections of learning disability services in the wake of the Winterbourne View scandal and seemed to make a valuable contribution with their insight into the care system.

But, as Sam Sly pointed out on Learning Disability Today’s Facebook page, the use of such experts is nothing new. The CQC’s predecessor, the Commission for Social Care Inspection, had similar arrangements but they were abandoned when the CQC was formed more than 3 years ago.

“If they'd carried on investing in people's expertise then we may be 10 steps forward instead of starting all over again,” she said. It is hard to argue with that point.

The reintroduction of ratings for care homes is another ‘back to the future’ move, but a logical one, as these were popular with the public when they were published in the past.

Some of the reaction to the CQC’s announcement on Twitter has been somewhat cynical, such as wondering if this is another paper exercise where little will change on the ground. This is an understandable reaction. Over the years the care inspection regime has had many reboots, with promises of increasing the rigour in inspections. But, scandals have continued to happen, which has then led to another bout of hand-wringing and more reforms.

Whether this new regime will help to improve service quality and prevent another Winterbourne View occurring only time will tell, but Sutcliffe’s intentions are good and hopefully the reforms will bring more rigour to the regulation of the adult social care system.